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wound care > Burns and Lymphedema exam 2 > Flashcards

Burns and Lymphedema exam 2 Flashcards

1
Q

when treating burns, what is our utmost concer?

A

infections

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2
Q

what source of thermal burns tends to cause full thickness burns?

A

contact

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3
Q

do direct or alternating current cause more damage?

A

alternating

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4
Q

will the entry wound or the exit wound of electrical burns have more superficial tissue damage?

A

exit wound

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5
Q

which layers of skin does first degree frostbite affect?

A

epidermis

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6
Q

what is the treatment for first degree frostbite?

A

just re-warming

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7
Q

what layer of skin do second degree frostbite burns affect?

A

epidermis and dermis

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8
Q

what layer of skin does third degree frostbite affect?

A

epi, dermis, subq

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9
Q

what layer of skin does fourth degree frostbite affect?

A

subq and deeper

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10
Q

how long does it take for the acute effects of radiation burns to manifest?

A

they manifest within 4 weeks

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11
Q

what source of burns makes up the majority of burns in young children?

A

Scalds (very hot liquid or steam)

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12
Q

what source of burns makes up the majority of burns in the working age adults?

A

flame

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13
Q

which zone in burn injuries has no tissue perfusion?

A

zone of coagulation/necrosis

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14
Q

what is the prognosis for the zone of stasis?

A

chance of tissue recovery if there is optimal management

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15
Q

which zone of burns has a likely chance of tissue recovery?

A

zone of hyperemia

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16
Q

what percent of TBSA needs to be burnt in order for there to be a systemic response?

A

20-30%

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17
Q

what are some systemic responses when the body has a complex burn?

A

hypotension, bronchoconstriction, 3x increase in BMR, reduced immune response

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18
Q

what factors does the Lund and Browder chart compensate for that the rule of nines does not?

A

age and body shape

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19
Q

what percent of TBSA does a pt’s one palm and fingers make up?

A

1%

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20
Q

what percent of TBSA would be burned if the entire trunk was burnt (not including the groin or neck)?

A

36%

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21
Q

what percent of TBSA does a child’s head comprise?

A

18%

22
Q

what percent of TBSA does the anterior portion of the left leg of a child comprise?

A

6.7%

23
Q

if a wound appears to be pale and pink, what burn type is it likely to be?

A

superficial dermal

24
Q

what is the prognosis for superficial epidermal burns? (healing timeline and scars)

A

7-14 days. No scars

25
Q

what is the prognosis for superficial dermal burns? (healing timeline and scars)

A

2-3 weeks. no scars

26
Q

what is the prognosis for deep dermal burns? (healing timeline and scars)

A

possibly surgery. possible scarring

27
Q

what is the prognosis for full thickness burns?

A

typically requires surgery

28
Q

what percent of TBSA classifies a burn as non-complex for adults and for children?

A

less than or equal to 15 and 10

29
Q

what areas are considered critical in regards to complexity of burns?

A

hands, feet, face, perineum, genitalia

30
Q

which type of burns requires management of blisters as part of the treatment?

A

superficial dermal

31
Q

what is the next step if during the wound treatment the wound appears to have a local infection?

A

tx with antimicrobial

32
Q

what is the next step if during the wound treatment the wound begins to progress to a full thickness burn?

A

refer to burn unit

33
Q

when is deroofing blisters advised?

A

when they are greater than 1 cm

34
Q

what type of dressing is typically effective in non-complex superficial dermal burns?

A

non-adhesive contact layer with a secondary absorbent layer

35
Q

what dressing selection is advised for superficial epidermal burns?

A

gels or moisture cream

36
Q

what are the three Rs associated with hypertrophic scarring?

A

raised, red, rigid

37
Q

what are risk factors for hypertrophic scarring (there is 6)?

A

inadequate first aid, poor wound management, infection, position while in hospital, comorbidities, deeper burn depth

38
Q

what types of burns are at a higher risk for hypertrophic scarring?

A

deep dermal burns

39
Q

what are some management techniques for hypertrophic scarring?

A

massage and moisture; pressure garments; contact media; laser scar therapy, splinting, mobility, functional training.

40
Q

how can PT help manage hypertrophic scarring?

A

improving mobility and function. splinting the area to stretch scar tissue and prevent contractures

41
Q

what special test is there for lymphedema?

A

stemmer’s sign

42
Q

what other diseases does pitting edema occur with?

A

CHF, CVI, and DM

43
Q

what is stage 1 of lymphedema?

A

spontaneous and reversible. there is pitting edema and elevation affects swelling

44
Q

what is stage 2 of lymphedema?

A

spontaneous and irreversible. No pitting edema and elevation does not help swelling

45
Q

what is stage 3 of lymphedema?

A

lymphostatic elephantiasis.

46
Q

How can one tell the difference between lipedema and lymphedema?

A

lipedema will be BL, have a - stemmer’s sign, no pitting edema and will mostly occur in younger females

47
Q

what is class 1 of compression garments and what stages of lymphedema would we use them for?

A

15-20 mmHg. nurses who stand a lot of mild lymphedema of UE

48
Q

what is class 2 of compression garments and what stages of lymphedema would we use them for?

A

20-30 mmHg. Moderate lymphedema of UE, mild in LE

49
Q

what is class 3 of compression garments and what stages of lymphedema would we use them for?

A

30-40 mmHg. Severe lymphedema in UE, moderate in LE.

50
Q

what is class 4 of compression garments and what stages of lymphedema would we use them for?

A

> 40 mmHg. Severe lymphedema in LE

51
Q

what signifigance does CKD play in a patient with lymphedema

A

must be careful performing manual lymph drainage b/c kidneys might not handle the uptake in fluid.

52
Q

when exercising with a pt who has lymphedema, what precautions should we take/things we should avoid?

A

repetetive UE movements

wound care (3 decks)

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